Five head lice myths busted

Lisa Hagman demonstrates the AirAll device on her daughter Sonja, 9, at Lice Clinics of America in Silverdale on Thursday. School districts' policy on excluding students who have lice have changed in the last decade.(Photo: MEEGAN M. REID / KITSAP SUN)Buy Photo

It started in October. Tiffany Daniel's daughter came home with head lice. Although Daniel was diligent in treating her daughter and the home environment, the lice came back.

Daniel was frustrated. "She kept coming home with it. We'd treat it over and over again," she said. "We'd treat ourselves, the house, our car ..."

Daniel and others in a Facebook discussion of head lice wondered why routine lice checks in schools are a thing of the past and why "they don't notify parents anymore."

South Kitsap School District, where Daniel's daughter goes to school, has done away with school-wide notification, although letters are sent home to a class if three or more students in the class have been confirmed with live lice during a one-month period.

"Evidence-based research has found that letters and lice screening programs have not been proven to have a significant effect on the incidence of head lice in the school setting," South Kitsap school officials said. "Letters highlighting cases of head lice have been shown to increase anxiety and cause social stigma and embarrassment, putting students’ rights to confidentiality at risk."

Most school districts over the past decade have moved away from strict "no nits" policies of yanking kids from class at the first sign of an infestation. Such policies have been shown in research to be not only ineffective, but harmful, said Vonnie Saucerman, director of nursing services for Central Kitsap and North Kitsap school districts.

"We send them home, and they're missing a whole day of instruction," Saucerman said

Head lice (Pediculosis humanus capitis) are tiny, wingless insects that live close to the human scalp and feed on human blood. An estimated 6 million to 12 million infestations occur each year in the United States, most commonly among children 3 to 11 years old.

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Lisa Hagman combs the hair of daughter Sonja, 9, at Lice Clinics of America in Silverdale with a special comb.(Photo: MEEGAN M. REID / KITSAP SUN)

Fact: Personal hygiene and household or school cleanliness are not factors for infestation. Head lice affect children of all socioeconomic levels.

Myth: Head lice carry diseases.

Fact: Head lice are not dangerous, and they do not transmit disease. Although the thought of bugs nesting in your hair can make your skin crawl, head lice are mainly a nuisance, manageable through early identification and persistent, thorough treatment. School nurses recommend parents take 15 minutes a week to inspect their child's head for signs of lice to nip outbreaks in the bud.

Myth: Schools are hotbeds of lice infestation.

Fact: Though a head lice infestation is often spotted at school, it is usually acquired elsewhere through head-to-head contact at sleepovers and camps. Although children should be encouraged not to share hats, hairbrushes, clothes and other personal items, the chances of transmission from these sources are low. It is unlikely to find head lice living on objects like helmets and hats because they have feet specifically designed to grasp on to the hair shaft of humans. Lice can't jump or fly and only move by crawling. Direct contact with a person who has live lice is the primary method of transmission.

Myth: Nits in the hair mean live lice are present.

Fact: Nits (eggs laid by the adult female head louse) are oval-shaped and tiny (about the size of a knot in thread). Nits take about eight or nine days to hatch. They need warmth from the scalp to do so.

Eggs that are likely to hatch are usually located no more than 1/4 inch from the scalp and firmly attached to the hair shaft. Nits that are further than 1/4 inch from the base of the hair shaft may be already hatched, non-viable nits or empty casings.

Misdiagnosis is common, the research shows. Dandruff, droplets of hairspray and empty casings are often mistaken for viable nits.

Lice nymphs mature into adults about nine to 12 days after hatching. An adult louse (about the size of a sesame seed) will live about 30 days on a person's head but will die within one or two days if it falls off the person.

Myth: Mayonnaise and other home remedies can get rid of head lice.

Fact: The theory is mayonnaise, oils and similar substances can suffocate head lice. But there is no scientific evidence that home remedies are effective treatments.

Truth: “Super lice” resist treatment.

Fact: A 2016 study showed that 48 states now have lice that are genetically predisposed to resistance to commonly used treatments. Diligent nit removal is the key to eliminating an infestation, according to Nicole Klein, health service program supervisor for the Washington State Office of the Superintendent of Public Instruction. “It does take tedious time of going through the hair,” Klein said. “You may have to do that every couple of days. Then a weekly cycle until you’ve gotten all the nits out.”

Given what's known about lice and their life cycle, the National Association of School Nurses recommends that children be allowed to remain in class for the remainder of the day when live lice or nits are found on their heads. Parents should be notified at the end of the day, and the student should be allowed to return to class once treatment has begun, even if the hair is not 100 percent nit-free. If live lice are found when a student returns to school, he or she is sent home again for further treatment.

Head checks at school are to be done discreetly, protecting the student’s privacy, the NASN recommends.

North Kitsap abandoned its no-nits police in 2008; Central Kitsap followed in 2009. Neither district sends letters home about a lice infestation (except to affected families). Newsletters periodically remind parents to regularly check their child along with other treatment and prevention tips. The new approach is working, Saucerman said,

"We have tracked it over the years," she said. "It's a very emotional subject for parents and staff. We did not make it worse. We had more kids in school, and we were actually able to pinpoint families with a problem."

For one reason or another, some families have trouble with persistent re-infestation, Saucerman said. In that case, parents may consider professional de-lousing treatment.

Lice Clinics of America (formerly Lice Girls of Bainbridge Island) opened its Silverdale office in June. Treatment programs range from $135 to $189 and involve an FDA-approved process in which heat is applied to the scalp to dehydrate the eggs. The hair is combed out to remove nits. A third step is to apply a nontoxic rinse that kills the lice.

The more expensive package includes the comb out, a recheck and retreatment if needed. With the less expensive package, parents do the comb-out at home. The in-clinic treatment takes 60 to 90 minutes. The heat treatment is not used on children under 4 years old.

Head lice prevention and treatment

Pre-emptive head checks: Health experts and schools recommend all parents check their children weekly for head lice whether or not they have signs.

Signs of infestation: Tickling, itching, irritability and difficulty sleeping (lice are more active at night), sores on head

How to check for lice: Under a bright light, look at your child’s head, starting with the back of the neck and behind the ears. Part hair into small sections, using a magnifying glass if available. Lice are about the size of a sesame seed. Nits are gray or whitish and attached firmly to the hair shaft.

Do: Remove lice and nits using a fine-tooth comb. Inspect and comb through small sections of hair removing lice or nits until no more are observed. Comb hair daily until no live lice are discovered for two weeks. This should take approximately 15 to 20 minutes a day.

Don’t: Use any pesticide or chemical not specifically labeled for treating head lice.

Do: Follow product instructions. Failure to retreat, as indicated, retreating too soon or too late are likely causes for reinfestation, according to the CDC.

Don’t: Apply treatment to hair that has been washed with conditioning shampoo or rinsed with hair conditioner, which acts as a barrier that keeps the medicine from adhering to the hair shaft.

Do: Wash clothes, towels, bed linens and other items using hot water (at least 130 degrees). Dry laundry at the highest setting for at least 20 minutes. Items that can’t be washed can be sealed in a plastic bag for two weeks.

Do: Soak combs and brushes in hot water (at least 130 degrees) for five to 10 minutes.

Do: Vacuum the floor and furniture, but don’t make yourself crazy. Lice die after one to two days at room temperature away from a host’s scalp.

Don’t: Use insecticide sprays or bombs. They aren’t needed and may unnecessarily expose your family to toxic chemicals.

Do: Check family members for lice. Preemptive treatment is not usually recommended for people without evidence of an active infestation.

Don’t: Treat pets. Head lice do not live on pets, and pets don’t play a role in spreading head lice.